Diphenyleneiodonium chloride inhibits MYCN-amplified neuroblastoma by targeting MYCN induced mitochondrial alterations

High-risk neuroblastoma is one of the most lethal childhood cancers. Half of these tumors are driven by MYCN gene amplification (MNA). Despite intensive chemo- and radiotherapy, only 40% of patients survive, and they often suffer from severe long-term side effects of these genotoxic treatments. Thus, new therapies are needed that are less toxic and more efficacious. Here, we identified diphenyleneiodonium (DPI) as a tool compound that preferentially targets MNA neuroblastoma. Using proteomic assays we investigated the DPI mode of action, finding that DPI induces the proteasomal degradation of MYCN and could reverse some alterations induced by high levels of MYCN. These include profound changes in the expression of proteins participating in the mitochondrial electron transport chain. Metabolic and biological assays suggested that alterations in mitochondrial function and the associated production of reactive oxygen species (ROS) are critical DPI targets in the context of MNA. DPI reduced the survival, and malignant transformation of neuroblastoma across a panel of cell lines at clinically achievable concentrations. DPI also shrank tumors and prevented metastatic spread in zebrafish models of MYCN-driven neuroblastoma. These findings suggest that processes impacted by complex I inhibitors could be valuable new targets for the development of non-genotoxic drugs against high-risk MNA neuroblastoma.